BACKGROUND The main structures anterior to the trachea are frequently poorly visualized by trans-oesophageal echocardiography (TEE) because of the tracheal air column. We studied a new acoustic window for TEE imaging of large vessels anterior to the trachea by using a saline-filled endotracheal balloon. METHODS Cardiac surgery patients were studied. After ventilation was discontinued at the b...

Right-sided aortic arch with an aberrant left innominate artery arising from the pulmonary is a very rare finding in tetralogy of fallot (TOF). A 2-year-old boy presented for routine intracardiac repair TOF. angiogram raised suspicion abnormal origin. 640-slice CT was done to delineate anatomy. The re-implanted descending aorta and performed.

症例は17歳男性．MCT-8欠損症による脳性麻痺，重度精神運動発達障害があり，10歳時に気管切開術を施行されていた．気管切開孔から大量出血を来たし，前医へ救急搬送された．造影CTで気管腕頭動脈瘻と診断し，緊急で腕頭動脈へのカバードステント留置にて止血した．1カ月後に再出血を認め，再度カバードステント留置にて止血した．再出血や感染のリスクがあるため，根治的手術目的に当科へ紹介となった．手術は左第3肋間レベルL字型胸骨部分切開にて縦隔内へアプローチし，腕頭動脈離断術を施行した．新規の神経学的後遺症や縦隔洞炎を認めず，術後25日目に転院した．術後2年10カ月を経過して再出血や感染を認めていない．気管腕頭動脈瘻は再出血や感染，神経学的後遺症を予防するための治療戦略を立て，可及的早期の外科的治療に踏み切ることが重要である．

Tracheo-innominate artery fistula (TIF) is a rare but life-threatening complication of tracheostomy. We describe a 44-year-old man who was admitted for a pressure ulcer infection with a third tracheostomy in place. He showed massive hemoptysis from the TIF, followed by cardiopulmonary arrest. The cuff of the tube was hyperinflated; however, even a slight movement of the tube resulted in recurre...

Innominate artery (IA) aneurysms represent 3% of all arterial aneurysms. Due to the risk of thromboembolic complications and spontaneous rupture, surgical repair is usually recommended on an early elective basis. We present the case of 81-year-old Caucasian male presenting with atypical anterior chest pain secondary to a large innominate artery aneurysm who underwent successful open surgical re...

cannulation of the carotid artery can be performed on the right or left side in accordance with vascular pathology. If the proper flow in the carotid artery cannot be restored by arch repair, which can occur occasionally when the repair of a dissected innominate artery bifurcation is not possible, an aorta-carotid bypass may be necessary and easily performed with a carotid side-graft used for c...